Paul S. Jowell, MD

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Services

• Esophageal Cancer
• Gastroenterology
• Gastrointestinal Cancer

Department / Division:
Medicine / Gastroenterology

Address:
DUMC 3662
Durham, NC 27710

Appointment Telephone:
(919) 684-6437

Office Telephone:
(919) 684-3625

Fax Telephone:
(919) 681-8785

• M.B., Ch.B., University of Cape Town Medical School, South Africa, 1983

• Internal Medicine, Albert Einstein Medical Center, Philadelphia, 1986-1989

• Gastroenterology, Duke University Medical Center, North Carolina, 1989-1991

Clinical Interests:
Diagnostic and therapeutic ERCP, diagnosis and staging of gastrointestinal and pancreatic malignancies, endoscopic ultrasound (EUS) including EUS guided fine needle aspiration; therapeutic endoscopy, management of pancreatitis and biliary and pancreatic stones and strictures

Research Interests:
My primary research interest is gastrointestinal endoscopy.  Areas of specific investigation relate to endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS)  pancreaticobiliary disorders, and competence and training in endoscopic procedures.

Most of my research is clinical.  I am participating in the following clinical trials.  PI in a study to evaluate whether secretin can prevent post ERCP pancreatitis.  I was PI in a study recently completed comparing endoscopic ultrasoune to CT guided fine needle aspiration in the diagnosis of pancreatic masses.

I am actively involved in several studies designed to correlate findings on endoscopic ultrasound with chronic pancreatitis on pancreatic biopsy, compare different types of FNA needles for pancreas masses, and evaluate the efficacy of celiac plexus block for patients with various types of abdominal pain

I have participated as an investigator in studies evaluating the relationship between abnormalities in the CFTR gene and patients with idiopathic pancreatitis.

Special areas of expertise are in endoscopic training and competence, therapeutic ERCP, and endoscopic ultrasound.

Key words: endoscopy training, endoscopy competence, ERCP, pancreatitis, quality improvement, complications, endoscopic ultrasound.

Representative Publications:
Gerke H, Jaffe TA, Mitchell RM, Byrne MF, Stiffler HL, Branch MS, Baillie J, Jowell PS. Endoscopic ultrasound and computer tomography are inaccurate methods of classifying cystic pancreatic lesions. Dig Liver Dis. 2006 Jan;38(1):39-44. (2006) Abstract

Volmar KE, Vollmer RT, Jowell PS, Nelson RC, Xie HB. Pancreatic FNA in 1000 cases: a comparison of imaging modalities. Gastrointest Endosc. 2005 Jun;61(7):854-61. (2005) Abstract

Green BT, Rockey DC, Portwood G, Tarnasky PR, Guarisco S, Branch MS, Leung J, Jowell P. Urgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial. Am J Gastroenterol. 2005 Nov;100(11):2395-402. (2005) Abstract

DeWitt J, Jowell P, Leblanc J, McHenry L, McGreevy K, Cramer H, Volmar K, Sherman S, Gress F. EUS-guided FNA of pancreatic metastases: a multicenter experience. Gastrointest Endosc. 2005 May;61(6):689-96. (2005) Abstract

Cohn JA, Mitchell RM, Jowell PS. The impact of cystic fibrosis and PSTI/SPINK1 gene mutations on susceptibility to chronic pancreatitis. Clin Lab Med. 2005 Mar;25(1):79-100. (2005) Abstract

Kalady MF, Peterson B, Baillie J, Onaitis MW, Abdul-Wahab OI, Howden JK, Jowell PS, Branch MS, Clary BM, Pappas TN, Tyler DS. Pancreatic duct strictures: identifying risk of malignancy. Ann Surg Oncol. 2004 Jun;11(6):581-8. (2004) Abstract

Gerke H, Byrne MF, Stiffler HL, Obando JV, Mitchell RM, Jowell PS, Branch MS, Baillie J. Outcome of endoscopic minor papillotomy in patients with symptomatic pancreas divisum. JOP. 2004 May;5(3):122-31. (2004) Abstract

Cohn JA, Mitchell RM, Jowell PS. The role of cystic fibrosis gene mutations in determining susceptibility to chronic pancreatitis. Gastroenterol Clin North Am. 2004 Dec;33(4):817-37, vii. (2004) Abstract

Byrne MF, Mitchell RM, Gerke H, Goller S, Stiffler HL, Golioto M, Branch MS, Jowell PS, Baillie J. The need for caution with topical anesthesia during endoscopic procedures, as liberal use may result in methemoglobinemia. J Clin Gastroenterol. 2004 Mar;38(3):225-9. (2004) Abstract

Byrne MF, Gerke H, Mitchell RM, Stiffler HL, McGrath K, Branch MS, Baillie J, Jowell PS. Yield of endoscopic ultrasound-guided fine-needle aspiration of bile duct lesions. Endoscopy. 2004 Aug;36(8):715-9. (2004) Abstract

Micames C, Jowell PS, White R, Paulson E, Nelson R, Morse M, Hurwitz H, Pappas T, Tyler D, McGrath K. Lower frequency of peritoneal carcinomatosis in patients with pancreatic cancer diagnosed by EUS-guided FNA vs. percutaneous FNA. Gastrointest Endosc. 2003 Nov;58(5):690-5. (2003) Abstract

Devereaux BM, Fein S, Purich E, Trout JR, Lehman GA, Fogel EL, Phillips S, Etemad R, Jowell P, Toskes PP, Sherman S. A new synthetic porcine secretin for facilitation of cannulation of the dorsal pancreatic duct at ERCP in patients with pancreas divisum: a multicenter, randomized, double-blind comparative study. Gastrointest Endosc. 2003 May;57(6):643-7. (2003) Abstract

Cotton PB, Connor P, McGee D, Jowell P, Nickl N, Schutz S, Leung J, Lee J, Libby E. Colonoscopy: practice variation among 69 hospital-based endoscopists. Gastrointest Endosc. 2003 Mar;57(3):352-7. (2003) Abstract

Byrne MF, Suhocki P, Mitchell RM, Pappas TN, Stiffler HL, Jowell PS, Branch MS, Baillie J. Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center. J Am Coll Surg. 2003 Aug;197(2):206-11. (2003) Abstract

tenBerge J, Hoffman BJ, Hawes RH, Van Enckevort C, Giovannini M, Erickson RA, Catalano MF, Fogel R, Mallery S, Faigel DO, Ferrari AP, Waxman I, Palazzo L, Ben-Menachem T, Jowell PS, McGrath KM, Kowalski TE, Nguyen CC, Wassef WY, Yamao K, Chak A, Greenwald BD, Woodward TA, Vilmann P, Sabbagh L, Wallace MB. EUS-guided fine needle aspiration of the liver: indications, yield, and safety based on an international survey of 167 cases. Gastrointest Endosc. 2002 Jun;55(7):859-62. (2002) Abstract

Mulcahy HE, Patel RS, Postic G, Eloubeidi MA, Vaughan JA, Wallace M, Barkun A, Jowell PS, Leung J, Libby E, Nickl N, Schutz S, Cotton PB. Yield of colonoscopy in patients with nonacute rectal bleeding: a multicenter database study of 1766 patients. Am J Gastroenterol. 2002 Feb;97(2):328-33. (2002) Abstract

Enns R, Eloubeidi MA, Mergener K, Jowell PS, Branch MS, Pappas TM, Baillie J. ERCP-related perforations: risk factors and management. Endoscopy. 2002 Apr;34(4):293-8. (2002) Abstract

Cohn JA, Noone PG, Jowell PS. Idiopathic pancreatitis related to CFTR: complex inheritance and identification of a modifier gene. J Investig Med. 2002 Sep;50(5):247S-255S. (2002) Abstract

Byrne MF, Jowell PS. Gastrointestinal imaging: endoscopic ultrasound. Gastroenterology. 2002 May;122(6):1631-48. (2002) Abstract

Bergin D, Ho LM, Jowell PS, Pappas TN, Paulson EK. Simple pancreatic cysts: CT and endosonographic appearances. AJR Am J Roentgenol. 2002 Apr;178(4):837-40. (2002) Abstract

White RR, Paulson EK, Freed KS, Keogan MT, Hurwitz HI, Lee C, Morse MA, Gottfried MR, Baillie J, Branch MS, Jowell PS, McGrath KM, Clary BM, Pappas TN, Tyler DS. Staging of pancreatic cancer before and after neoadjuvant chemoradiation. J Gastrointest Surg. 2001 Nov-Dec;5(6):626-33. (2001) Abstract

Wallace MB, Durkalski VL, Vaughan J, Palesch YY, Libby ED, Jowell PS, Nickl NJ, Schutz SM, Leung JW, Cotton PB. Age and alarm symptoms do not predict endoscopic findings among patients with dyspepsia: a multicentre database study. Gut. 2001 Jul;49(1):29-34. (2001) Abstract

Noone PG, Zhou Z, Silverman LM, Jowell PS, Knowles MR, Cohn JA. Cystic fibrosis gene mutations and pancreatitis risk: relation to epithelial ion transport and trypsin inhibitor gene mutations. Gastroenterology. 2001 Dec;121(6):1310-9. (2001) Abstract

Gress FG. Adams TL. Bozymski EM. Brown RD. Edelstein MA. Jowell PS. Patel RS. Soetikno RM. Stevens PD. Zfass AM. Erickson RA. Kowdley KV. The guideline for advanced endoscopic training. Gastrointestinal Endoscopy. 54(2):288, 2001 (2001)

McGrath KM, Jowell PS. Endoscopic ultrasound. State of the art. N C Med J. 2000 Jan-Feb;61(1):408-12. (2000) Abstract

Jowell PS, Robuck-Mangum G, Mergener K, Branch MS, Purich ED, Fein SH. A double-blind, randomized, dose response study testing the pharmacological efficacy of synthetic porcine secretin. Aliment Pharmacol Ther. 2000 Dec;14(12):1679-84. (2000) Abstract

Cohn JA, Bornstein JD, Jowell PS. Cystic fibrosis mutations and genetic predisposition to idiopathic chronic pancreatitis. Med Clin North Am. 2000 May;84(3):621-31, ix. (2000) Abstract

Anscher MS, Lee C, Hurwitz H, Tyler D, Prosnitz LR, Jowell P, Rosner G, Samulski T, Dewhirst MW. A pilot study of preoperative continuous infusion 5-fluorouracil, external microwave hyperthermia, and external beam radiotherapy for treatment of locally advanced, unresectable, or recurrent rectal cancer. Int J Radiat Oncol Biol Phys. 2000 Jun 1;47(3):719-24. (2000) Abstract

Cohn JA, Jowell PS. Are mutations in the cystic fibrosis gene important in chronic pancreatitis? Surg Clin North Am. 1999 Aug;79(4):723-31, viii. (1999) Abstract

Cohn JA, Friedman KJ, Noone PG, Knowles MR, Silverman LM, Jowell PS. Relation between mutations of the cystic fibrosis gene and idiopathic pancreatitis. N Engl J Med. 1998 Sep 3;339(10):653-8. (1998) Abstract

Jowell PS, Eisen G, Onken J, Bute BP, Ginsberg B. Patient-controlled analgesia for conscious sedation during endoscopic retrograde cholangiopancreatography: a randomized controlled trial. Gastrointest Endosc. 1996 May;43(5):490-4. (1996) Abstract

Jowell PS, Baillie J, Branch MS, Affronti J, Browning CL, Bute BP. Quantitative assessment of procedural competence. A prospective study of training in endoscopic retrograde cholangiopancreatography. Ann Intern Med. 1996 Dec 15;125(12):983-9. (1996) Abstract

Jowell PS, Epstein S, Ismail F, Hollis B, Schwartz IR. Alteration in osteoblast activity and nutritional vitamin-D deficiency in non-hypercalcemic malignancy. Calcif Tissue Int. 1988 Jan;42(1):18-22. (1988) Abstract

Jowell PS, Epstein S, Fallon MD, Reinhardt TA, Ismail F. 1,25-Dihydroxyvitamin D3 modulates glucocorticoid-induced alteration in serum bone Gla protein and bone histomorphometry. Endocrinology. 1987 Feb;120(2):531-6. (1987) Abstract